December 08, 2011

Area(s) of Interest:

Sacramento – The Department of Health Care Services (DHCS) has once again moved to balance the state’s budget on the backs of the poorest and most vulnerable Californians in their recent announcement that they would retroactively recoup Medi-Cal reimbursements paid to providers since June 1, 2011.

The California Legislature passed and Governor Brown signed AB 97, which included a 10 percent reimbursement rate cut for health care providers. Federal approval was required before the state could implement the proposed cuts. In October of this year, the cuts were approved, giving DHCS the authority to implement cuts to the program that provides health care services to low-income seniors, families, children, and people with disabilities.

“DHCS has ignored independent data showing that Medi-Cal patients already have a more difficult time accessing care,” California Medical Association (CMA) CEO Dustin Corcoran said. “CMA and other providers believe that these cuts are on their face, illegal, and we’ve recently filed a lawsuit to that end. The announcement that DHCS will begin recouping Medi-Cal fees retroactively, dating back to June of this year, is a surefire way to reduce access to care for patients who need it most.”

“We are facing serious cuts on a number of fronts,” James T. Hay, M.D., CMA President said. “These cuts will have a drastic impact on the number of Medi-Cal patients doctors are able to see if they can even afford to continue seeing any, and the news of retroactive recoupment will certainly only make that worse”

The press release on the DHCS website indicates that "DHCS intends to retroactively recoup any Medi-Cal reimbursements paid to providers since June 1, 2011," but does not provide any details or timeline for how the actual collected of money will work.

“Physicians are facing a 27.4 percent reduction in Medicare payments as early as January, along with the already approved 10 percent Medi-Cal reductions. With the news of retroactive recoupment, DHCS is effectively making it impossible for the practice of medicine to continue in the communities that need it most,” Corcoran added.